ABSTRACT
Background: Split skin grafting is widely used surgical procedure for the treatment of ulcers. Graft survival depends on number of factors like vascularity, wound infection etc, diabetes is associated with endothelial dysfunction, neuropathy, wound infection which collectively affect the graft survival. Objective of this study was to compare the amount of graft uptake, the post-operative complications and survival of split thickness skin graft in diabetic and non-diabetic ulcer.Methods: In our prospective comparative study total 112 patients with ulcer were included of which 56 were diabetic and 56 were non-diabetic. All of them underwent split skin grafting as part of their wound management. Comparison was made between two groups in terms of amount of graft uptake, post-operative wound infection, revisional surgery, donor site infection.Results: Compared with non-diabetics, diabetics have significantly less graft uptake (p<0.001). out of 56 patients in diabetic group 4 (66.7%) underwent revisional surgery, out of 56 patients in non-diabetic group 2 (33.3) patients underwent revisional surgery (p value is <0.68) which is statistically insignificant. 3 (60%) out of 56 in diabetic group developed post-operative graft infection, 2 (40%) out of 56 in non-diabetic group developed graft infection (p=1, not significant). One patient in the study developed donor site infection. Among 112 cases, only 1 case had donor site infection with diabetic.Conclusions: Diabetes is associated with poor graft uptake and post-operative complication rates in patients undergoing split skin grafting.
ABSTRACT
Skin is considered to be the best covering of Human body. Because it interfaces with the environment, it plays an important immunity role in protecting the body against pathogens [1]. Skin performs many important and crucial functions of body, therefore loss of skin results in many complications. Because of which it is imperative to cover skin loss at the earliest. There are many options available to cover skin loss and one of the best and convenient methods is Split skin Grafting (SSG). However, SSG fails, if not fixed. If not fixed, mobilization of graft may occur leading to failed revascularization and then necrosis of graft. Therefore, it is mandatory to fix the split skin graft to donor site for its survival. Many techniques and materials have been used for fixation of split skin graft. Each has its merit and demerit. In this article, we present comparative study of effectiveness of fixation of SSG with sutures versus Cyanoacrylate tissue adhesive
ABSTRACT
Snakebite is very common especially in Asia. We report a rare case of Providencia rettgeri infection following snakebite on the foot. This patient was treated with early and aggressive wound debridement, daily wound dressing during hospitalization and then skin coverage with split skin graft. No anti venom was given administered. Appropriate intravenous antibiotics were given to the patient while hospitalized and oral antibiotic were prescribed upon discharge. The outcome of this treatment was successful.